MRC/UVRI Uganda Research Unit on AIDS.
J Infect Dis. 2013 Dec 15;208(12):2007-16. doi: 10.1093/infdis/jit397. Epub 2013 Jul 31.
Helminth and malaria coinfections are common in the tropics. We investigated the hypothesis that prenatal exposure to these parasites might influence susceptibility to malaria in childhood.
In a birth cohort of 2345 mother-child pairs in Uganda, maternal helminth and malaria infection status was determined during pregnancy, and childhood malaria episodes were recorded from birth to age 5 years. We examined associations between maternal infections and malaria in the offspring.
Common maternal infections were hookworm (45%), Mansonella perstans (21%), Schistosoma mansoni (18%), and Plasmodium falciparum (11%). At age 5 years, 69% of the children were still under follow-up. The incidence of malaria was 34 episodes per 100 child-years, and the mean prevalence of asymptomatic malaria at annual visits was 5.4%. Maternal hookworm and M. perstans infections were associated with an increased rate of childhood clinical malaria (adjusted hazard ratio [aHR], 1.24, 95% confidence interval [CI], 1.10-1.41; aHR, 1.20, 95% CI, 1.05-1.38, respectively). S. mansoni infection had no consistent association with childhood malaria.
This is the first report of an association between helminth infections in pregnancy and malaria in the offspring and indicates that helminth infections in pregnancy may increase the burden of childhood malaria morbidity.
在热带地区，寄生虫和疟疾的合并感染很常见。我们研究了这样一种假设，即孕妇在孕期接触这些寄生虫可能会影响其子女在儿童时期对疟疾的易感性。
在乌干达的一个 2345 对母婴队列中，在孕期确定了母亲的寄生虫和疟疾感染状况，并在出生到 5 岁期间记录了儿童的疟疾发作情况。我们研究了母体感染与后代疟疾之间的关联。
常见的母体感染是钩虫（45%）、曼氏裂头蚴（21%）、曼氏血吸虫（18%）和恶性疟原虫（11%）。在 5 岁时，仍有 69%的儿童在接受随访。疟疾的发病率为每 100 名儿童年 34 例，在年度就诊时无症状疟疾的平均患病率为 5.4%。母亲感染钩虫和曼氏裂头蚴与儿童临床疟疾的发生率增加有关（校正风险比[aHR]，1.24，95%置信区间[CI]，1.10-1.41；aHR，1.20，95%CI，1.05-1.38）。曼氏血吸虫感染与儿童疟疾之间没有一致的关联。
这是首次报道孕期寄生虫感染与后代疟疾之间的关联，表明孕期寄生虫感染可能会增加儿童疟疾发病率的负担。
